In addition to being licensed as a Professional Counselor, I am also a Certified Clinical Hypnotherapist so
it should not surprise you to know that I was reading Belleruth Naparstek’s blog, Health Journeys today and stumbled across an excellent post she wrote (back in August) on getting reimbursement from insurance companies for the use of mind-body tools. Here is what I took away from her post . . . .
Don’t make things harder than they need to be. It reminds me of what my first partner, a scrub tech, used to tell me . . . . A surgeon can call a mass “a mass” or “a cyst” or “cancer.” And, for some masses more than one of those words may be accurate. However, the rate of reimbursement was / is contingent upon what s/he chooses to call it. The same is true for your services. Sometimes you have choices . . . and it benefits both you and your client to make both accurate and informed choices when it comes to the services you provide.
Persuasion is simply “applied empathy.” It is a skill that you have either developed or you have not. Don’t psych yourself out when talking with managed care. If you have the ability to apply your empathy to your client, you also have that same ability to apply your empathy to those who work in managed care. Put yourself in their seats so that you can speak to their unique concerns – those of balancing health care and restricting costs. And, if you are unable to apply your empathy there, then check yourself. That may be a skill that needs polishing . . . as it would benefit both you and your client.
Language matters. I know I’ve written about this before. Belleruth’s references to both managed care and the military are excellent examples of why this is so important. Different cultures speak different languages. If you are choosing to work within the culture of managed care, learn the language.
You need a Supporting Data File. Belleruth refers to this as “robust research data.” Whatever you call it . . . for whatever you do . . . keep your research data file current and easily accessible. It may be what gives you the upper hand in securing a contract to provide your services. (And, if a portion of what you offer falls under Complimentary / Alternative Medicine, then you need to double your efforts here.)
Doing your homework on each insurance company goes hand in hand with strategic networking. You’ll need both in order to find and persuade those with the influence necessary to approve of your mind-body services.
If you have additional tips that have helped you secure reimbursement for your services, I hope you’ll take a moment to share them below with our readers.
Hey Tamara! Nice post. This made me think of the creative writing I used to have to do for medicaid notes. I quickly learned to use certain terms and words in place of others (that really meant the same thing).
Hi, Jill! Welcome back! Hey, care to share some examples of terms and words that tend to be more managed-care-friendly?
Well I would definitely stay away from passive language, use more observations, things the client said or did specifically. For example, instead of saying you worked on coping skills, identify what skill specifically (we practiced deep breathing in session), and they really like it when you can quote something a client says. Quantifying goals and objectives would also make it more managed care friendly, like using a timeframe for achieving that goal, or what the client will learn to do instead of the thing they are trying to change (like client will talk to their spouse when they are upset instead of using x,y, or z). The most challenging to me are the notes for my non-directive play therapy clients, especially if the child is not very verbal. I find myself having to base a lot of my notes on observations, and also try to explain concepts/what the child is learning during the play to people who may not understand or know about play therapy. I am sure there are some other readers who run into the same thing, and I welcome any feedback on writing for play therapy clients.
Jill, thank you for dropping back in to share some of your tips for working with managed care. While I no longer choose to work directly with managed care, I can say that both the language and observationals skills that we learn by necessity when working with managed care are invaluable to all therapists. You are providing excellent examples of that here.
I’m eager to hear from others, too, who can expand this conversation – especially those who might be able to provide Jill with some tips / language that would support the work of non-directive play therapists. Don’t be shy! Here’s a great place to share what you know!